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Descriptive Transcript of Hearing Loss Matters

[Logo appears for TPT Twin Cities PBS]

[Music in the background]

Female narrator: "Hearing Loss Matters" is a coproduction of the Commission of Deaf, DeafBlind, and Hard of Hearing Minnesotans and Twin Cities PBS.

[Words appear: Portions of the audio in this program have been intentionally distorted to emulate the effects of hearing loss.]

[birds trilling, scene of Flowers swaying in a breeze]

- I guess it depends on how long you live, but I think it's inevitable. 

[scene of kids run down a sidewalk.]

[tires squealing and engine revving]

- You just have to slow down when you're talking to them, be a little more patient.

 [whirring and clacking, scene of a hydraulic jackhammer breaking up concrete.]

- Yeah, my grandma, she can barely hear us.

[distorted, indistinct chatter]

-Umm, It's difficult trying to communicate with them and frustrating.

[Music in the background]

Male narrator: It's a story we've all heard. As you get older, you lose your hearing. Conversations become harder to follow. Music doesn't sing like it used to.

[distorted music]

And your own family starts yelling across the dinner table, which doesn't help, by the way.

[scene of woman speaking distortedly, the man across from her looks puzzled, music in the background.]

Narrator: This is the timeless story of hearing loss.

[title appears, “Hearing Loss Matters]

[upbeat music]

Narrator: [Music in the background] Even today, in the age of commercial spaceflight and instant global communication, [beeping sounds of satellites] it's staggering just how common age-related hearing loss really is. After arthritis and heart disease, it's the third most common chronic condition affecting older adults. Two out of every three of us will experience it personally once we're in our 70s. And of those, 2/3 have noticeable hearing loss before the age of 60.

[An animated diagram of a brain]

Narrator: But here's the real problem: it turns out hearing loss isn't just an inconvenience; the newest research is showing us it literally alters the brain and not in a good way. In one study, adults with mild hearing loss were two times more likely to develop dementia than those without hearing loss. Adults with severe hearing loss were five times more likely. In fact, if age-related hearing loss goes untreated, your brain literally shrinks. It's true. If you can't hear what's going on, your brain gets smaller, leading to depression, isolation, and even a measurable drop in your IQ. Despite these statistics, only around one in eight doctors screen for hearing loss during a routine physical, and less than one in seven adults who have hearing loss choose to purchase hearing aids. Plus, get this: even that one person who does get hearing aids, on average, they wait ten years from their initial diagnosis before making the purchase, and even when they do, they don't use their hearing aids regularly. That's a full decade and beyond of shrinking brains, dropping IQs, and hour after hour of unnecessary yelling. It doesn't have to be like this. We now have choices. It's just that, for some reason, we don't live like we do.

[Scene in In a radio studio, a sign reads KFAI 90.3, 106.7.]

[woman speaking indistinctly]

Laura Waterman Wittstock, First Person Radio (speaking on radio): Three seconds.

[woman speaking indistinctly]

Laura (speaking on radio): And it is 9:00, and here are the news headlines with Brian McCall.

- And good morning...

Laura: I came to Minnesota in 1973. Radio has always been something that has been a special part of my life.

Laura (speaking on radio): This is First Person Radio. I am Laura Waterman Wittstock.

Laura: My father was 76 when he died. And he came to visit me when he was about 74, and that's when I realized that he had hearing loss that was rather profound. He could still hear a little bit. And he did not use hearing aids. And it raised a question in my mind. Is this from the work that they did during their lifetime, or is this something that is in our family? And then, fast-forward about ten years when I was in my mid-50s, I began to experience some hearing loss. I'm 77 now. So it's taken quite a long time.

Laura (speaking on radio): Well, welcome to First Person Radio, Graham Hartley.

Laura: When you start to lose hearing, you think it will not get worse, and it does. It does inevitably.

[Man on radio, distorted: “The payment, or the payout, of that $2,500...”]

Laura: But since I could still hear conversation, I ignored the loss that was occurring.

Laura (speaking on radio): How many coaches did you say?

[Person on radio, off-screen, distorted: “We're trying to pull together a one-to-one match...”]

Laura: Just recently, I decided, "Well, now is the time." Because my family was, you know-- I kept saying, "What? What?" And sometimes they would laugh, and sometimes they wouldn't. And I began to feel self-conscious. So I went and got tested, and I have a severe loss, and they said that once I get fitted, which will be in a few weeks, I will have to relearn how to hear.

[Man on radio: “That is significant.”]

Laura (speaking on radio) - Mm-hmm.

Laura: But life is life, and we do what we do as human beings. And I look forward to my hearing aids with a great deal of optimism.

[man speaking indistinctly]

Monique Hammond, Author: The older we become, actually hearing loss becomes more frequent for people, simply because oftentimes it's said that there is a lot of wear and tear on our, you know, hearing structures. So it seems to be a little bit the luck of the draw and then also how we lead our lives.

Dr. Frank R. Lin, Johns Hopkins: There's hearing loss in children, which fortunately, I think, for over two decades now, we've long recognized as critically important. But when we look at hearing loss in older adults, right, there's much more apathy about that type of hearing loss, and we're just now beginning to understand, the last several years, though, that it's incredibly impactful for things like cognitive decline or risk of dementia, falls, even preventing hospitalizations, that we're seeing that hearing loss is linked with all of these outcomes very, very strongly.

Christine Morgan, Hearing Loss Association of America: The important thing for someone who suspects that they have hearing loss and they usually can tell by having trouble hearing in groups, also having trouble hearing on the telephone--it's to go to an audiologist and get a hearing exam. That's the only way you can tell if you have a hearing loss.

Katherine Bouton, Author: I think that for a lot of people it's a combination of not wanting to acknowledge hearing loss, but also genuinely not really being aware of how much their hearing is declining.

Narrator: Now, as we've just seen, Laura is a talented working professional, but hearing loss was impacting her quality of life, which is why she decided to get tested. But what does this mean, "to get tested?" To show you, we've teamed up with the University of Minnesota, and their department of Speech, Language, and Hearing Sciences, and we began, in true academic fashion, with an anatomy lesson.

Sarah Angerman, Audiologist [standing in front of a diagram of the inner ear]: The process of hearing is a very elegant one. So we trap sound using this outer part of our ear, called the pinna, or the auricle. And there's a hole, then, that sound is funneled into that leads down into the ear canal. At the end of the ear canal is the eardrum, which is also called the tympanic membrane, and this vibrates in response to sound waves. Behind the eardrum are the three smallest bones in our body, and individually, they're called the malleus, the incus, and the stapes. The stapes is the smallest bone, and it interfaces with our cochlea, or our inner ear. So as these bones vibrate, there's a lever action that's created when the eardrum vibrates, and that vibration, then, of these bones is displacing fluid that fills this cochlea, or inner ear cavity. There's a membrane all along the snail-shaped inner ear structure that has thousands and thousands of cells that sit upon it, and so as that fluid is displacing the membrane, those cells are being stimulated, and the stimulation of those cells releases a neurotransmitter that sends information along the auditory nerve and up to the brain.  So there are two main types of hearing loss. One type is a conductive hearing loss, meaning that there's something in the outer ear or the middle ear that is preventing sound from getting through those parts of the ear. One example is wax. So if we had complete wax impaction in our outer ear, it would be acting essentially as an earplug, and sound would struggle to get through that area. Another example would be if we had fluid building up behind our eardrum in this space we call the middle ear. That might happen if we had an ear infection. That, too, is almost acting like an earplug, and sound cannot get through. So those two areas would create a conductive hearing loss, which can often be medically managed. However, what's more common for adults would be to have a loss in the inner ear, and this type of loss is called a sensorineural hearing loss, which is generally permanent. It's the common hearing loss to see as part of the normal aging process, and it is also the type of hearing loss that would be experienced by somebody who has had noise exposure. Noise exposure damages the cells that are contained within the inner ear, and once they're gone, they're gone for good. So when you lose hearing as a result of noise exposure, that loss is there for the rest of your life.

Narrator: Thank you, Sarah. And now let's get tested. The patient you're about to meet is not actually experiencing hearing loss. His name is Dr. Robert Schalock. The answers he's giving are meant to be representative of the typical hearing loss patient.

Female audiologist:  Just generally, what brings you in today?

Dr. Schalock: I have trouble hearing in noisy backgrounds.

Female audiologist: Okay.

Narrator: After the questions, it's common to perform a visual exam of the eardrum to make sure there are no obstructions that would inhibit the evaluation procedure.

Female audiologist: Perfect.

Narrator: Next, Robert is moved into a soundproof room for a series of tests.

Female audiologist: Okay, so for this part, we're gonna put the headphones on your ears. Just whenever you hear a beeping sound, I'm gonna have you press that button there for me, if you will.


Narrator: When Robert is finished, it's time to discuss the results.

Female audiologist - So just to orient you here, this is what we call an audiogram. This side here is volume, so very soft sounds going down to very, very loud sounds. And across the top is pitch or frequency.

Narrator: Now, if this chart were real, the next step would be to discuss treatment options, such as hearing aids.

Female audiologist: So generally speaking, they're kind of lumped into two categories. So there's what we call the custom hearing aids. The other options are versions of what we call a behind-the-ear hearing aid.

Katherine: Hearing aids these days can easily cost up to $4,000 for a single hearing aid, and since most hearing loss is from noise or aging, it tends to be bilateral, in both ears. So that means you need two hearing aids at $4,000 apiece.

Dr. Lin: The 1965 Medicare Act statutorily precludes coverage of hearing aids, and that was written at a time--50 years ago--when it probably made sense. They weren't very effective back then. They weren't even necessarily very expensive back then. In 50 years, though, a lot of things have changed, in terms of the cost, in terms of how we know how effective they are for things-- even just maintaining our daily functioning and improving our quality of life, not to mention hopefully things like dementia. So I think that will cause reevaluation.

[Different female audiologist, Holly Dodds, leading a female patient, Deena Ness, through a clinic door] - Come on right in here.

Narrator: In a few minutes, we'll also show you a real-life screening with a first-time patient. But first, we want to introduce two more adults who are experiencing hearing loss, and as they will share with us, not all forms of age-related hearing loss take years to develop.

[gentle piano music playing]

Kathleen Marin [scene of her playing piano]:  I started playing when I was eight. It sounds kind of overwhelming to say it, but to me, it's been everything. It's been the heart and soul of my life, other than friends and family, of course.


[scene of a framed photo on the piano of Liliana Marin holding a flute]

Liliana Marin: My mom--we are really close, and, yeah, I can talk to her about anything. I was in college. I came home for spring break. And that is when she told me.


Kathleen: I woke up, and I was deaf on my left side. The two most likely suspects are a very small stroke, right in the middle ear, or a viral infection. So we don't know, and we'll never know.

[muffled piano music playing]

Kathleen: Music doesn't sound musical to me anymore out of my right ear. It sounds like hammers hitting the pins that hold the strings.

[distorted piano music playing]


Kathleen: Once I got used to the hearing aids--and they're a challenge to get used to sometimes--life is so much better.

[stirring piano music playing]

Male voice:  “She puts in a molded thimble-sized hearing aid and keeps playing.”


Kathleen: And the day I got it, my daughter and I experimented, and we put on CD after CD, and I could hear everything. It was so amazing.


[scene of a collection of wood flutes sitting on a table and a drawing of a flute hangs on a wall]

Liliana: I think that's what they need to do. They just need to make that first step and just have people in their corner to help them.


Monique Hammond, Author: We cannot avoid every single virus that is out there, every lurking bacteria. You know, that's difficult to do. And then we also cannot avoid our genetics.

Dr. Frank R. Lin, Johns Hopkins: When you can't hear well, it's not so much you can't hear actually; it's more that your ear is constantly sending a garbled sound to your brain. So we're learning now that people with any amount of hearing loss, their brains are literally having to work harder, constantly processing that very, very degraded sound, and in turn, that load on the brain likely precipitates or can contribute to faster rates of loss of thinking and memory abilities and your risk of dementia.

Katherine Bouton, Author: The fact is that hearing aids these days are small, invisible. They work really well for people with mild to moderate hearing loss, and they can make an enormous difference in how you go about your daily life.

[birds chirping]

[scene of a man going through a photo album]

Rick Polski, Pico Rangers: Should have a picture of her somewhere.

Narrator: Rick Polski is a Vietnam veteran, and he represents another example of the many ways hearing loss can enter a person's life.

[scene of soldiers firing machine-guns in a jungle, noise of gunfire is evident]

Rick: I served in '69, '70 in Quang Tri, Vietnam, with the B Company Rangers. We did long-range patrols. We're the eyes and ears for the 5th Mechanized Unit, and so you can imagine whispering and then having all that noise for the first five minutes of your contact. It's deafening.

[explosion booms]

Rick: Yeah, your ears will ring.

[scene of an exploding grenade]

Rick: You know, it's just--the war machine's loud. That's all I can tell you.


[scene of Rick playing the banjo]

Rick: You know, I never noticed it till I was told I should go in and get it checked, and that was 40 years later, and when I did, they said I've had it a long time, and they gave me 50% bilateral hearing loss. And soon as I got my hearing aids, I couldn't wear 'em around my wife because she's been yelling at me for 30 years.


[scene of Rick staking a tomato plant]

Rick: You got doctor appointments, you better hear what the doctor's saying or bring an interpreter with you that can hear, because, you know, your life could depend on it. Hearing is definitely key for my survival.


[scene of soldiers prowling through a brush]

Rick: I can't hold a grudge. Life's too short. Because if you get mean or get ugly on something, it's gonna carry over into your life, and, you know, so I know I've got to live every day like it's my last, and I'm doing it.

[bird trilling]

Rick: Yeah, that one bird you hear now, that's--I can hear that loud and clear.


[bird trills]

Rick: You only got one chance around this thing called life, and you want to be able to hear what's going on around you, plus seeing--that and your vision, two important things.

[motorcycle engine revving, Rick drives off on a motorcycle]

Narrator: For many adults like Laura, hearing loss is a gradual process. For others, like Kathleen, it can be very sudden. And for combat veterans like Rick, the origins are hard to miss. But regardless of the cause, many forms of hearing loss can be improved using technology. So let's do a quick overview, starting with the common hearing aid.

[animation of hearing aids and hearables in difference sizes]

[bright acoustic guitar music]

Narrator: Hearing aids are actually like prescription eyeglasses. They need to be programmed by an audiologist to match your specific hearing loss. The results can be impressive, but they are also expensive, and they are not covered by Medicare or most insurance policies.

[animation of an ‘X’ drawn through a caduceus, which is a symbol of medicine]


Narrator: Hearables, or personal sound amplification products, are often confused with hearing aids but are actually over-the-counter solutions. Their quality really varies. After all, they are usually one size fits all, but they are much more affordable, and many people find them helpful. For those with truly profound hearing loss, there are cochlear implants. These devices combine a surgically implanted component and a small device worn behind the ear to turn sound waves into electrical impulses the brain can understand. Beyond this, there are assistive listening devices, which, like hearables, can be purchased over the counter. Assistive listening devices are frequently used to amplify conversations or the TV.

[animation of man speaks indistinctly and the sound transmitted to a second person wearing an assistive listening device]

Narrator: It also turns out, under the Americans with Disabilities Act, public venues like theaters and lecture halls are required to provide assistive listening devices, and if they have a hearing loop, it can transmit sound wirelessly to the T-coil in your hardware without the need to request additional equipment. And don't forget the apps. There are countless downloadable programs that have been developed to make life easier for those with hearing loss. There's also a whole host of products that don't rely on sound at all-- alarm clocks and fire alarms that vibrate your bed, as well as kitchen appliances and doorbells that blink and flash. And finally, there are strategies like getting someone's attention before speaking, turning off background noises, facing each other while talking that improve communication more than any technology and cost nothing at all. Bottom line: there is a technology or strategy for almost any situation which means you don't have to tough it out. Because remember, toughing it out has consequences.

Katherine Bouton, Author: People like to say we hear with our brain, and what happens is that the speech pathways of the brain, if they're not receiving those speech signals, get taken over by other functions, by other—usually other sensory functions. So when you finally do correct the hearing loss, those speech pathways have become-- they're not there for you to use anymore. You have to train them all over again, so it makes learning to hear with a hearing aid and especially with a cochlear implant much more difficult.

Russell Henderson, Treatment Advocate: To me, if it isn't taken care of, you're automatically making yourself look older, because you're constantly saying, "What did you say?" Or you have to turn your TV up real loud. And with your hearing aids, you can have the sound at a normal level.

Christine Morgan, Hearing Loss Association of America: It was a major decision to get a cochlear implant.

Christine (speaking in front of an audience): I have to tell you a little funny story about that. I was sitting with my older son, so I was giving him a hard time, 'cause he didn't wear sunglasses. And I said, "Do you realize when you're outside, and you're not wearing sunglasses, you could get glaucoma, you could get fish, and you could get cataracts, yada, yada, yada"? And he said to me, "I will wear sunglasses when you get a hearing aid."


Christine: It was difficult for me to make the decision because they're drilling into your head. And it's made, you know--Even though it's day surgery, I think it's major surgery. So it was a hard decision, but one I was absolutely glad I made.

Russell: You're happier, I think, because you are able to be more a part of the group because you're understanding what is being said.

Narrator: This is Deena Ness. Unlike the other adults we've profiled today, she's never had a hearing evaluation, but she has recently noticed she's having difficulty tracking phone conversations.

Holly Dodds, audiologist: What's bringing you in to see us today?

Deena: Well, there's been some concern with my family.

Narrator: When Deena was done, we sat down with both her and her audiologist to discuss the results.

Holly: I didn't see anything that would raise any red flags for me. I didn't see any evidence of any ear disease. I didn't see significant amounts of hearing loss, so...

Deena: I told my girlfriend that I was doing this, and she goes, "Well, what would happen if, you know, they told you you needed a hearing aid?" And I'm like, "I would get one."


Deena: 'Cause I was like...

Narrator: For Deena, the results were very positive, and her audiologist didn't recommend any further interventions. But even so, she's glad she took the time.

Deena: I was kind of excited to find out what this is. At the end of the day, I wanted to establish my timeline.

[scene of Deena heading outside]

Narrator: We're now going to turn our attention back to Laura and Kathleen. Shortly after our first interview, Laura was given a new pair of hearing aids, and Kathleen made a return trip to her audiologist to receive a newly calibrated model that may improve her ability to hear music.

Kathleen Marin: It's a different fit.

[scene of the audiologist turning on a stereo and Kathleen smiling]

[stirring piano music]

Kathleen: Oh, my goodness. Wonderful.


Kathleen: Oh, my God, I can hear it. Oh, my gosh. I knew that was the part.

Ann Abel, Audiologist: It was better.

Kathleen: It was a better quality sound.

Ann: Okay.

Kathleen: I couldn't hear every note, not that I expected to, but I could hear enough that I--that I had no blank spots.

Ann: Okay.

Kathleen: Well, so far, it's good news. Had I not been seeking treatment and really thinking things through, I wouldn't have figured out how to hear music again. And it's helpful for the family and friends. It's better for everybody.

Laura Waterman Wittstock: Well, the first thing was to select the type of hearing aid. And there's very expensive, and there's not-so-expensive, and then there's the middle. So I chose the middle.

Laura (talking to her dog in her yard) - We have raspberries.

Laura: I was shocked when I first put them on, and-- because I can hear myself more than anything, and then all of a sudden, I started to hear, you know, ambient sound-- the clicking of my car instruments, things like that that I just had not noticed in a long time. You know, in the radio show, I can just crank the sound up, and what I get is loud, but I don't get nuance. The difference is-- with the digital hearing aids--is, I get nuance. Why did I wait so long? I have no idea.


Narrator: And there you have it, the story of hearing loss as it stands today. As we've seen-- or maybe I should say, as we've heard--hearing loss is so much more than just a natural part of aging. It's a chronic health condition with all sorts of negative outcomes, from social isolation to a higher chance of falling or crashing and to an increased risk of developing dementia.

[animation of questions marks hovering over an animated brain]

[upbeat music]

Narrator: In short, it's not just a personal health issue; it's a public health issue, and here's why:

[animation of human figures filling the screen]

Narrator: With 10,000 baby boomers turning 65 every day for the next 15 years, the number of people with hearing loss is going to increase significantly, and as we know now from extensive research, adults with hearing loss are 57% more likely to have deep episodes of stress and depression. And social isolation, which often comes hand in hand with hearing loss, is a key factor in morbidity and mortality, not to mention those shrinking brains and diminishing IQs. Hearing loss really is just the first domino in a much larger chain reaction, and all these dominos together, they lead to increased health care costs and more medical interventions, all of which have a real impact on families, retirement plans, and state and federal budgets. So why go down that road, especially when we don't have to? The good news is that treating hearing loss isn't like fixing a heart or replacing a knee. It's an almost no-risk proposition, and it has a direct and positive impact on your quality of life.

[animation of trees sprouting by a river and birds flying overhead as the sun crests the horizon]

[words appear: Hearing Loss Matters]

[Deaf and Hard of Hearing Services: 1-800-311-1148]

[birds chirping]


[Credits: Narrator: Alan Tilson, Producer: David Gillette, Associate Producer: Carrie Clark, Line Producer: Amanda Reardon]

[Credits: Director of Photograph: Jim Kron, Additional Videography: Yoshi Katagiri, Field Audio/Sweetening: Joe Demko, Additional Audio: Eric Pagel]

[Credits: Design Direction: Jon Van Amber, Motion Graphics: Kimberly Zamora Pearson, Illustrator: Robert Edward V, Editor: Nathan Reopelle]

[Credits: Additional Footage/Stills provided by: Veterans Museum. Additional Reading: “What Did You Say?” by Monique Hammond, “Living Better with Hearing Loss” by Katherine Bouton.]

[Credits: Special thanks: Mayo Clinic, Mark DeReuiter, Beth Crotty, T.J. Pavey, Minnesota Public Radio, Jayne Solinger, Julie Siple, Tom Weber, Ariel Tilson]

[Credits: Communications & Relationships Coordinator: Cassandra Fenelon, Media Asset Production Assistant: Alyssa Fuller, Tanner Schelle, Director of Production: Katherine Gibson]

[Credits: Sr. Director, Supervising Producer: Sherece Lamke, Vice President, MN Productions & Partnerships: Lucy Swift]

[Credits: Chief Content Officer Terry O’Reilly. Copyright 2015, Minnesota Commission of the Deaf, DeafBlind and Hard of Hearing and Twin Cities PBS]

Female announcer: "Hearing Loss Matters" is a coproduction of the Commission of Deaf, DeafBlind, and Hard of Hearing Minnesotans and Twin Cities PBS.

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